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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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LIFESTYLE
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910
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1600 - Food Program
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PR0548046
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COMPLIANCE INFO
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Entry Properties
Last modified
6/5/2026 9:06:14 AM
Creation date
6/5/2026 9:04:20 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0548046
PE
1695 - TEMPORARY EVENT
FACILITY_ID
FA0027418
FACILITY_NAME
ORCHARD VALLEY FARMERS MARKET
STREET_NUMBER
910
STREET_NAME
LIFESTYLE
STREET_TYPE
ST
City
MANTECA
Zip
95336
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\tchampion
Supplemental fields
Site Address
910 LIFESTYLE ST MANTECA 95336
Tags
EHD - Public
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https://mail.google.eom/mail/u/0/7ogblDocument_2022-10-20_003322.jpg <br />Environmental Health DepartmentSAN JOAOUIN <br />10 <br />11 <br />OR <br />12 <br />13 <br />"Important*’ <br />Completed by14 <br />^Health Permit * <br />T«.3*»Sj5 <br />3'1.1 Us« <br />0 J <br />1Ice Cooler <br />10/20/2022, 7:17 PM1 of 1 <br />vw.-; ■■ <br />S G4 -ta»C <br />SOfe/ry - f ta’lt’*, <br />tw <br />I r .;' J ‘ .41 « <br />..... <br />Title <br />I M4t 4 wtttT /MtiiH <br />1 <br />/ 1I <br />G«rb»g« <br />Can <br />'J' <br />I am providing the following cold temperature control for the cold holdmg of potentially hazardous foods below <br />45 F (if food is used the following day maintain below 41 F temperature) <br />□ ice chests ^3 Refrigerator <br />□ Refrigerated truck LJ Ice bath and tubs <br />□ Other (specify) <br />| a4 *i« Bajk S *= '' "’i. it I* <br />4 irxH# «■-< er* <br />I am providing the following items within my booth for the sanitary cleaning of food preparat.on utensil <br />{^KThree compartment sink <br />[J Three deep tubs (basms 6-8 indies minimum), one for soapy water, one for rinsing and one far a bleach <br />solution (one tablespoon of bleach per gallon of water) <br />^Detergent, bleach, and wiping cloths (cleaning towels) <br />3” fub to store wiping cloths m bleach solution <br />I am providing the following for adequate hand washing facHit.es. but separate from utens.l wash within my <br />booth <br />Signature <br />□ Paper towels and puinPi5tYfa_5oap container <br />Names of responsible persons to be present in booth dunng all hours of operation <br />‘Ae.iifxg Q-air\^4) ( __K.ija<iV2S?A^j----/Vrrr~ ~z-oO——............... . ....... <br />All food vendor booths are sutnect to inspection. Please make a copy of this aPP^at,°" "J <br />nrenarahon for this event A copy of this checklist must be in the booth at all hours of <br />pre^X and Return original to festival coordmator three weeks pnarjo <br />Date <br />® Water supply d.spenser wnh warm water at a minimum of 100 F (i.e. 5-20 gallon conta-ner with spigot) <br />□ One separate tub (bucket or basin) for the collection of nnse/wastewater. <br />fhw tvatw
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